Christine Nicole Penwell, MA LPC
Individual provider Active NPI Counselor · Milan, MI
NPI 1215500236 · NPPES record last updated Dec 6, 2024
Key facts
- NPI
- 1215500236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 7336 (TN)
- Practice address
- 516 Ideal St
Milan, MI 48160-1415 - Phone
- (615) 630-0550
- NPI assigned
- Jul 19, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7336 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Trailblazer Family Counseling PLLC | Current |
Accepting new patients | |
| Centerstone of Tennessee, Inc. | Past |
Accepting new patients |
Interoperability endpoints
- harmonyfamilycenter.nikkipenwell@143071.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 7336 | TN | Yes |
Addresses
Primary practice location
516 Ideal St
Milan, MI 48160-1415
Mailing address
516 Ideal St
Milan, MI 48160-1415
Phone (615) 630-0550
Other providers in Milan, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 6, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.